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My baby is wheezing. Is it asthma?

Though it may be alarming to hear your baby wheezing (a whistling sound), it may not be due to asthma.

As many as 30 per cent of young children have at least one episode of wheezing by the time they are three years old. This is usually when they have a virus or an upper-respiratory tract infection such as a throat infection or a cold (GINA 2012). Once the infection has gone, the wheezing problem usually settles. Most babies outgrow these viral-related symptoms by the time they start school (Rull 2010).

If your baby wheezes frequently but doesn't have a cold, ask your GP for their opinion.

What are the symptoms of asthma?

A baby's airways are so small that they can make a wheezing sound which isn't true asthma. Wheezing can be quite common in children under the age of three (GINA 2012).

Asthma is a long-term (chronic) inflammation of the small breathing tubes (bronchioles) in your baby's lungs. Your doctor will only make a firm diagnosis of asthma when they see a pattern of symptoms emerging over a period of time. Considering your family's medical history will also help with the diagnosis (GINA 2012).

Symptoms of asthma are:

A persistent, dry cough, which is worse late at night, or early in the morning.

It may be difficult to know whether or not your baby has asthma. So your doctor may treat her with asthma medications for a short time (GINA 2012). If the symptoms improve as a result, the chances are that your baby has asthma.

What causes asthma?

Asthma in most babies is a reaction to a trigger, often an allergen such as pet saliva, skin or urine, dust mites, or pollen. Airborne irritants such as cigarette smoke and mould spores can also be triggers (CKS 2011).

However, a respiratory infection, usually caused by virus such as a cold, may also cause an attack (NHS 2012, CKS 2011).

As in other types of allergies, the trigger for the attack stimulates antibodies to produce histamine and other allergy chemicals. In asthma, these chemical reactions happen in your baby's lungs. Chemicals released by the antibodies swell the lining of your baby's lungs and tighten the muscles of her airways. Mucus is also produced.

Why may my baby be more likely to develop asthma?

Asthma may be more likely to develop if:

You or your partner smoke. This makes her nearly four times more likely to wheeze compared with a baby in a smoke-free home (GINA 2012).

One or both of your baby's parents have asthma, or another allergic condition, such as eczema. This may mean that she develops it earlier than babies who don’t have asthma in the family (NHS 2012, CKS 2011).

Your baby has an allergic condition such as eczema, or a food allergy (CKS 2011, GINA 2012).

Your baby lives in a home that has damp or mould problems (Asthma UK nd, GINA 2009, Rull 2010).

I've heard asthma's on the rise. Why?

Asthma has been on the increase over the past few decades, but it has started to level off. Experts aren't sure why, but one possibility is that children's immune systems are less mature than they used to be.

Babies' immune systems were once busy fighting diseases such as rubella and whooping cough. But now that there are fewer infectious diseases to fight off, their immune sytems may be more immature.

This means that your baby's immune system may respond to an allergen a little too zealously, and this may contribute to her asthma (Rees 2005). Some experts suggest that early exposure to certain bacteria may help babies to develop effective immune systems that can ward off allergies, including asthma.

Babies living on farms tend to have lower rates of asthma, possibly because they are exposed to a wide range of bacteria (Adler et al 2005, Ege et al 2011, Eriksson et al 2010, GINA 2012).

Can asthma be cured?

Asthma is a long-term (chronic) condition, and there is no known cure (Asthma UK nd, NHS 2012). However, many children outgrow their asthma, or find that it becomes less severe when they get older.

In the meantime, you can help to manage your baby's asthma with medicines, and by reducing her exposure to the trigger for the asthma when you can. Work with your doctor to find the best treatment and method to manage your baby's asthma.

If your baby has asthma, it shouldn't prevent her from taking exercise and leading a healthy, active lifestyle as she grows. Your GP will tailor your baby's treatment so that she can run around and play without triggering her asthma. Exercise will help her to control her asthma and keep her strong.

Last reviewed: October 2013

References

Adler A, Tager I, Quintero DR. 2005. Decreased prevalence of asthma among farm-reared children compared with those who are rural but not farm-reared. Journal of Allergy and Clinical Immunology. 115(1): 67-73

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